Officials talk about potential Medicaid expansion elimination

Feb. 06--ASHLAND -- The Kentucky Medical Association President believes local medical providers would have to do some "scrambling" if the Medicaid expansion is revoked, as Gov. Matt Bevin has threatened.

In an executive order recently filed by Bevin, he directed his administration to end the state's Medicaid benefits for those in the expansion if the courts strike down any part of his Medicaid work requirement plan.

"As you know we do have a rather large Medicaid society here--big segment of our population--so I would think we'd all have to do some scrambling around to make sure we could make ends meet and keep things going," said KMA President Dr. Maurice Oakley, an Ashland Ophthalmology specialist.

On Jan. 12 Bevin announced that Kentucky is the first state given authority to require "able bodied adults" on Medicaid to work in exchange for health coverage.

The Daily Independent previously reported that under the 1115 waiver, about half of Kentucky residents who are covered under the Medicaid expansion authorized by the Affordable Care Act will be required to work 20 hours a week or volunteer in their communities for that many hours each week or receive the equivalent number of hours of education.

Gov. Steve Beshear, Bevin's predecessor, expanded Medicaid coverage in Kentucky in which over 480,000 residents enrolled. This made the state's total Medicaid enrollment come to almost 1.4 million and caused even more of a burden to the state's budget.

In a statement from Our Lady of Bellefonte Hospital Communications and Advocacy Specialist Kevin Compton, Compton stated that the hospital understands the dire fiscal circumstances facing the state and said the 1115 waiver is something the hospital is "cautiously monitoring."

"The eyes of the nation are on Kentucky to see how this is implemented in the state and if legal challenges to it will emerge. The biggest concern OLBH has with the waiver is if it may lead to 500,000 Kentuckians losing their Medicaid coverage. One of the mission priorities of Bon Secours Ministries is Medicaid expansion," the statement said.

In another statement from King's Daughters Health System, President and CEO Kristie Whitlatch said long-term improvement to healthcare will be achieved when individuals, communities, providers and insurers work together.

"King's Daughters Health System is committed to working with all stakeholders to reduce the cost of healthcare and improve the health of the communities we serve," the statement said.

Michael Rust, President of the Kentucky Hospital Association, said he believes if the expansion were to go away that Bevin would "work very hard" to make sure that people do have coverage. He also noted that he feels it's everyone's goal to improve the health of Kentuckians.

"Any change to the system, you know, could be detrimental or it could be advantageous and I'm not really sure, we'll have to wait and see," he said.

For local hospitals, Rust said there is potential that revoking the Medicaid expansion could increase the bad debt they have.

"If the court would strike down work requirement or cancel expansion a lot of it would be factored on how (Bevin) would eliminate the whole program and how it would actually be structured after that," said Rust.

Oakley said he currently does not have much information on the Medicaid work requirement, noting the one thing providers need to know for sure when they see a patient is that there is some way of telling if they still qualify for Medicaid.

Even though the work requirement is still in its early stages, Oakley believes it will be a success and said he thought it was a good move for the state.

"It's worth a try, it really is. Time will only tell us if it's going to work or not but something's gotta give somewhere," he said.

Oakley also said he felt the work requirement is fair, explaining Medicaid is good insurance to have.

"To require a little something to kind of be in the game like the governor said makes you feel a little better about it. It's just like if you have a job and you're working you feel better when you make that paycheck then if you're not and I think it'll give people a little bit more pride," he said, adding it may also make citizens give more thought into visiting the doctor or going to the hospital as often as they normally do.

Oakley continued, saying there is going to be a lot of changes down the road within the next year or two years that are going to involve Medicaid and health insurance.

"It's time we do something about all of these things now so there won't be a problem all the time," he said.

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